06. Interpretation of Plasma Fluphenazine Levels
Key Points
- Fluphenazine decanoate has very different kinetics than haloperidol decanoate.
- The short Tmax may be useful at times.
- The minimum threshold for response is 0.81 ng/mL.
- Very few patients will tolerate fluphenazine levels above 3.0 ng/mL.
- 4.0 ng/mL represents the point of futility, beyond which one is unlikely to find greater efficacy, even if tolerated.
- If high plasma levels are obtained, one should not reflexively reduce the dose drastically.
- Instead document that the patient appears to be tolerating this current level, and then order a repeat level.
- If it remains high, and there is some doubt about whether the patient requires this level, the dose should be decreased by no more than 10% per month to prevent rebound psychosis.
To unlock this video you need to become a Bronze, Silver, Gold, Bronze extended, Silver extended or Gold extended Member.
Check Our CME ProgramDownloads for Offline Access
- Download Video (MP4)
- Download Audio File (MP3)
